Extinction of Fear Memories with Glucocorticoids in Veterans with PTSD

糖皮质激素可消除患有 PTSD 的退伍军人的恐惧记忆

• 批准号: 8838095
• 负责人: CAROL S NORTH
• 金额: --
• 依托单位: VA NORTH TEXAS HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-01 至 2012-04-01
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8838095
• 关键词: Accidents; Animal Model; Animals; Behavior Therapy; Development; Disease; Double-Blind Method; Event; Extinction (Psychology); Forcible intercourse; Freedom; Fright; Future; General Population; Glucocorticoids; Human; Image; Imagery; Individual; Intervention; Investigation; Longevity; Measures; Medical; Memory; Mental Depression; Methodology; Nightmare; Oral; Outcome Measure; Outcome Study; Participant; Patient Self-Report; Patients; Pharmacotherapy; Physiological; Placebos; Post-Traumatic Stress Disorders; Prevalence; Process; Provider; Randomized Controlled Clinical Trials; Research; Research Design; Risk Estimate; Rodent; Services; Severities; Stimulus; Symptoms; Techniques; Terrorism; Testing; Time; Trauma; Veterans; War; Work; abstracting; base; combat; cost; depressive symptoms; effective therapy; neurochemistry; novel; novel strategies; operation; post intervention; prevent; psychologic; rapid technique; response; social; translational study

Abstract There are very few systematic studies on humans that focus on changing the underlying traumatic memory once PTSD has been established. The proposed project is a translational study based on our work with animal models of PTSD in which coricosterone augmented extinction of contextual fear memories. The study design is a double-blind randomized controlled clinical trial involving eighty-eight OEF/OIF veterans with combat-related PTSD. We plan to pair multiple fear memory reactivations, using a scripted imagery technique, with an oral glucocorticoid or placebo. Participants will be followed at 1, 3, and 6 months post intervention to measure the longevity of the expected effect. Outcome measures will include PTSD symptom severity, depression symptoms severity, and physiological measures. Specific Aims/Hypothesis: Aim 1: Examine the effects of glucocorticoid administration following traumatic memory reactivation on psychiatric symptoms in veterans with combat-related PTSD. Specific hypotheses to be tested: (A) Subjects who receive an exogenous glucocorticoid after traumatic memory reactivation will demonstrate fewer PTSD and depression symptoms one week later, compared to those who receive a placebo after traumatic memory reactivation. (B) The glucocorticoid reduction effects will be cumulative; that is, reduction will persist, and further post- reactivation glucocorticoid administration will further reduce symptoms. (C) Decreases in PTSD and depression symptoms will persist at 1, 3, and 6 months for subjects receiving an exogenous glucocorticoid compared to those subjects receiving placebo. Aim 2: Examine the effects of glucocorticoid administration following traumatic memory reactivation on physiological responses to veteran's personal combat memories. (D) Subjects who receive an exogenous glucocorticoid after traumatic memory reactivation will demonstrate decreased physiological responses one week later, compared to those who receive a placebo after traumatic memory reactivation. (E) As with the psychological measures, suppression of the physiological measures will demonstrate both persistence over time and accumulation with subsequent post-reactivation glucocorticoid administration.

抽象的 关于人类的系统研究很少，一次重点是改变基本的创伤记忆 已建立了PTSD。拟议的项目是一项基于我们与动物模型的工作的转化研究 PTSD的冠状球酮增强了情境恐惧记忆的灭绝。研究设计是 双盲随机对照临床试验涉及与战斗有关的88个OEF/OIF退伍军人 PTSD。我们计划使用脚本图像技术将多个恐惧记忆重新激活与口头配对 糖皮质激素或安慰剂。干预后1、3和6个月将遵循参与者 期望效应的寿命。结果指标将包括PTSD症状严重程度，抑郁症 症状严重程度和生理措施。 具体目的/假设： 目标1：检查创伤性记忆重新激活后糖皮质激素给药的影响 与战斗有关的PTSD的退伍军人的精神病症状。 要测试的特定假设： （a）创伤记忆重新激活后接受外源糖皮质激素的受试者将证明 一周后的PTSD和抑郁症状较少，与那些接受安慰剂的人相比 创伤性记忆重新激活。 （b）糖皮质激素还原作用将是累积的；也就是说，减少将继续存在，并在 糖皮质激素的再活化将进一步减轻症状。 （c）受试者的减少和抑郁症状的减少在1、3和6个月会持续 与接受安慰剂的受试者相比，外源性糖皮质激素。 目标2：检查创伤性记忆重新激活后糖皮质激素给药的影响 对退伍军人个人战斗记忆的生理反应。 （d）创伤记忆重新激活后接受外源糖皮质激素的受试者将证明 一周后的生理反应减少了，与那些接受安慰剂的人相比 创伤性记忆重新激活。 （e）与心理措施一样，抑制生理措施将证明 随后的持续时间和积累，随后的反应后糖皮质激素给药。